Friday, October 11, 2019

Medicare open enrollment 10/15/19 to 12/7/19

What is it?
Medicare open enrollment is the time you can choose and enroll in Medicare Advantage plans (optional private insurance HMO or PPO plans you can choose instead of getting your Medicare benefits through the government) and Medicare Part D Prescription Drug plans (all private insurance plans, there is no government option). Changes you make during this period take effect 1/1/2020.

Where to get help
Your county senior center can get you connected with a SHIP (State Health Insurance Assistance Program) counselor trained to assist you with Medicare open enrollment. Our state ADRN (Aging and Disability Resource Network) can also help 1-866-981-2372. Medicare's Plan Finder tool online at offers comparisons of Medicare Advantage and Part D prescription drug plans, or you can call 1-800-MEDICARE to get list of plans in your area and then find out from each plan directly what they offer.

Tips about Medicare open enrollment
Keep notes when you talk to anyone: when, who you spoke to, what you asked or told, what they told you in response, what next steps they said they would take, what next steps they recommended you take, etc.

Verify what anyone tells you by checking online or written materials, address conflicting info you find before making enrollment changes.

Changing plans? Enroll directly through Medicare rather than through the insurer. That increases your likelihood that Medicare will have the right plan enrollment information for you.

What's new this year:

Planfinder searches
Personalized searches require you to log into your account, or create one if you don't already have one. You can do a basic anonymous search by giving some personal information.

Medicare Advantage
Expanded benefits may be available with Medicare Advantage plans, including some non-medical services and services for beneficiaries with chronic conditions like nutrition services, home modification, in-home supports.

As always, Medicare Advantage plans have networks of covered doctors, hospitals, and other providers. Those networks can change providers during the year, too. Whether you are changing or staying in the same plan you may as well check to be sure your providers are covered in your 2020 plan, though that network may change later.

For those who want to leave their Medicare Advantage plan and go back to original Medicare we used to have a separate Medicare Advantage Disenrollment Period. Now instead we have Medicare Advantage Open Enrollment period Jan 1 through March 31 every year. You may make one change during this period, either leave to go back to original Medicare, or switch from one Medicare Advantage to another.

Part D Prescription Drug plans
The average premium for 2020 is $32.74, down a little from last year. The donut hole gap of coverage starts once you reach $4,020 in drug costs in 2020, and catastrophic coverage picks up after you pay out $6,350.

As always, the formularies of covered drugs change so whether you are changing or staying in the same plan check to see if your regular prescriptions are on the list and what your copays will be.

Medicare beneficiaries who get Extra Help (the Low-Income Subsidy also called LIS) can change their Part D plan once a calendar quarter.


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